Prevention network lacks clear guidelines

By Wang Jung-chang 王榮璋

My quarantine at home for SARS is finally over. I never left my home and abided by all the related measures during this period. I therefore believe that I have fulfilled my social responsibility. But there is something that I have to say in light of my personal experience over the past two weeks.

Based on my experience, I realize that SARS prevention cannot solely rely on the public's conscience. Today, the government's health agencies only call on suspected patients through moral exhortation to undergo domestic quarantine voluntarily. But they failed to provide a necessary "SARS quarantine guide" that clearly lists what those under quarantine should and should not do. A disease prevention network merely built on the public's conscience is fragile.

To test your knowledge of SARS quarantine, just ask yourself: Do you know that there are two kinds of quarantinees: those who have recently been to SARS-infected areas and those who have been in frequent contact with SARS patients? Do you know that the quarantine rules for the two are not exactly the same? Should their family members also be quarantined? Do you know how to deal with their clothing, dining utensils and garbage? What should a quarantined person do if he or she does not have a mask or clinical thermometer?

These problems seem to be minor ones. But related health agencies never contacted me or instructed me about the various quarantine rules, as I was trying to protect my family members, neighbors and community. Under such circumstances, I could do nothing but rely on my own efforts -- such as checking the epidemic information online, calling the Department of Health (DOH), and asking advice from my doctor friends.

Unfortunately, quarantinees who live alone without any information from the outside world, may easily become loop-holes in the prevention network due to the lack of information.

Take Taipei City's homeless people, for example. The media have portrayed them as "unstable bombs scattered across the city," or "widespread sources of infection." Even those with sufficient information may not know how to protect themselves. Since the homeless do not watch TV or read newspapers, isn't their lack of SARS-related information the government's responsibility?

For those who purposely violate quarantine rules, the government should certainly punish them heavily. However, can't it provide a complete "SARS quarantine guide" to those who need to be isolated when issuing a quarantine order?.

The DOH has, in fact, announced that it will publish a quarantine guide for those who are under home quarantine. Hopefully, as the old Chinese saying goes, "It's not too late to mend the sheepfold after a sheep is lost."

In the war against SARS, one can imagine the pressure facing our health workers at the grassroots level. But this is exactly the time that we need them the most. Besides, there are still ways to solve the current manpower shortage. My suggestions for the government are:

First, it should appropriately use local community staff. For example, village or borough chiefs and representatives can assist health officials to deliver quarantine orders while teaching every household in their communities about SARS prevention.

Second it should cooperate with religious, social welfare and other civil groups. It can entrust certain quarantine matters to them.